Arterial Hypertension Is Associated with Increased Serum Lipoprotein(a) Levels in End-Stage Renal Disease Patients.

In addition to disorders in lipoprotein metabolism, several other factors are involved in the development of atherosclerotic changes in end-stage renal disease (ESRD) patients. One of these is arterial hypertension. We evaluated serum lipids-total cholesterol (TC), triglycerides (TG), apolipoproteins (A , A , B, E), lipoprotein(a) [Lp(a)]-in 109 ESRD patients on dialysis [46 on hemodialysis (HD); 63 on continuous ambulatory peritoneal dialysis (CAPD)] and in 45 hyperlipidemic patients without renal failure (HL group). Dialysis patients were divided in two groups. Group A included 42 hypertensive patients (mean age: 62.3 ± 15.5 years) whose blood pressure (BP) was satisfactorily controlled with anti-hypertensive medications. Group B included 67 non hypertensive patients (mean age: 66.6 ± 11.9 years). Levels of Lp(a) were significantly higher in both the HD (p = 0.001) and the CAPD (p < 0.05) patients as compared with the HL group. When the HD and CAPD groups were divided into hypertensive and non hypertensive patients, Lp(a) levels were significantly higher in the hypertensive patients; this difference was not observed among non renal failure patients. These results indicate that arterial hypertension is associated with elevated Lp(a) serum levels in ESRD patients undergoing either HD or CAPD.